title: T2-weighted and T1-weighted dynamic superparamagnetic iron oxide (ferucarbotran) enhanced MRI of hepatocellular carcinoma and hyperplastic nodules.
abstract: OBJECTIVE
  Iron oxide contrast medium (ferucarbotran) shortens both T1 and T2 relaxation time. We used the T2- and the T1-weighted dynamic ferucarbotran-enhanced magnetic resonance (MR) imaging to predict the histologic grade of hepatocellular carcinoma (HCC) and to distinguish HCC from hyperplastic nodules.
  
  
  METHODS
  Forty-three patients with 48 representative hepatic lesions (13 well differentiated HCC, 19 moderately differentiated HCC, 4 poorly differentiated HCC, 12 hyperplastic nodules) were included in the study. T1-weighted image, T2-weighted turbo spin echo, and T2*EPI (echo-planar) images were obtained before and after ferucarbotran injection. The percentage T2 signal intensity loss (T2 PSIL) of the tumors was calculated at 5 minutes and 25 minutes after contrast injection. The enhancement in dynamic T1 images was interpreted by two independent radiologists.
  
  
  RESULTS
  The T2 PSIL of well differentiated HCC was 39.5 +/- 8.23%, moderately differentiated HCC was 26.4 +/- 13.78%, poorly differentiated HCC was 4.4 +/- 9.42%, and hyperplastic nodules was 44.3 +/- 11.04%. Comparison of T2 PSIL showed significant differences in the three histologically graded HCCs (p < 0.001), but not between the well differentiated HCCs and hyperplastic nodules (p > 0.05). Delayed post-contrast (25 minutes) T2-weighted images were not necessary and shortened the examination time. In the post contrast dynamic T1 study, no significant differences between all the groups was seen.
  
  
  CONCLUSIONS
  Ferucarbotran MR images help in differentiating the different histologic grades of HCC but T2 PSIL could not differentiate hyperplastic nodules from well differentiated HCC. Dynamic post contrast T1-weighted images provide no additional information.
authors.affiliation: Department of Radiology, Taipei City Hospital Ren-Ai Branch, Taiwan. chenranchou@yahoo.com.tw
authors.forename: Ran-Chou
authors.initials: RC
authors.lastname: Chen
authors.forename: Jiunn-Ming
authors.initials: JM
authors.lastname: Lii
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Chou
authors.forename: Ting-An
authors.initials: TA
authors.lastname: Chang
authors.forename: Wei-Tsung
authors.initials: WT
authors.lastname: Chen
authors.forename: Chao-Shiang
authors.initials: CS
authors.lastname: Li
authors.forename: Hsing-Yang
authors.initials: HY
authors.lastname: Tu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D003911:Dextrans; D003937:Diagnosis, Differential; D005260:Female; D052203:Ferrosoferric Oxide; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis*; D006801:Humans; D007501:Iron; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010087:Oxides; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide